失智症高齡者團體家屋行為與空間使用特性之探討─以台灣天母團體家屋為例─

A Study of Behaviors and Space in the Dementia Elderly Group Home - Example from Taiwan Tianmu Group Home -

郭成森(Cheng-Sen Kuo)

指導教授 ： 曾光宗

中原大學/設計學院/建築研究所/碩士(2013年)

https://doi.org/10.6840/CYCU.2013.00399

摘要

由於高齡者的快速成長，預估2017年後台灣將由高齡化社會邁入高齡社會，年齡的增加是失智症最之重要之危險因子，故伴隨而來的失智症高齡者相關照顧問題將更為迫切需要解決。然而，國人對於失智症相關知識的不了解；照顧設施服務量的不足、品質的不良；政府的福利政策有限等情況下，不但無法因應現階段的失智症照顧，更別說是高齡化急速成長的未來。有鑑於此，本研究針對台灣高齡者平均餘命最高、人口所佔比例甚多的台北市，並以台灣首創之天母家屋為對象，欲達成下列目的：

一、分別探討台灣失智症高齡者天母家屋與日本團體家屋，其成立背景、發展過程、照顧服務與建築環境。
二、探究台灣失智症高齡者於天母家屋內，其行為、空間之使用特性，以及二者間的相互關聯性。
三、提出適合台灣在地的建議方案，作為未來團體家屋照顧與環境方面的改善對策，成為普及化營運的參考依據。

在採用研究方法的面向上，首先經由｢理論與文獻回顧法｣，了解失智症、高齡者的特性，以及行為類別、空間領域相關理論的分類構成，並從日本團體家屋、台灣天母家屋的成立背景、發展過程、照顧服務、建築環境，作為本研究欲探討主題的背景與基礎。此外，透過｢參與式觀察法｣的田野調查，實地記錄繪製使用現況，依天母家屋內寶貝家、長青家二單元，採用時間量對行為的發生時間與空間的使用時間進行分析，且經由使用動線累積圖、滯留空間圓描圖，探討天母家屋內失智症高齡者的行為、空間之使用特性，以及二者間的相互關聯。更進一步地，經由觀察與探究的過程，得出本研究之結果發現。

本研究經由研究分析歸納整理後，針對失智症高齡者於行為與空間二者間，相互關聯的使用特性，分別從行為、空間、照顧等三面向，提出下述結論：一、失智症高齡者行為特性以必要性行為、精神行為症狀的嗜睡為主；二、休閒行為、精神行為症狀的遊走分佈空間使用範圍最廣；三、行為與空間使用主要受到活動作息安排而有所影響；四、失智症高齡者空間使用以室內空間為主；五、客廳空間與開放式廚房設計具有彈性運用，較能誘發活動參與度；六、懷舊感生活場所營造較少，降低失智症高齡者對環境的安定感，易造成部分精神行為症狀的發生；七、戶外庭院空間之自然景觀規劃，增加失智症高齡者相互交流，進而產生心靈愉悅感與療癒性作用；八、因應照顧服務員人力配置，為了顧慮失智症高齡者安全，影響部分精神行為症狀的發生或無法紓解。而後並提出建議方案，以供參考。

關鍵字

失智症高齡者 ； 團體家屋 ； 天母家屋 ； 日本團體家屋

並列摘要

As the rapidly growth of the elders, society of Taiwan will enter an aged society in the year of 2017. And increasing of age is the most factor that caused dementia. It is necessary to solve the relative problems of servicing dementia elderly. However, fewer knowledge of Dementia, lack of the service in caring facilities, low quality and the limitation of the government welfare policy, it can’t cope with the Dementia at the present stage, not to mention the rapid growth of aging society. So, this study aim to the highest average age of aging people that have the highest percentage of number of people in Taiwan, which is Taipei city, and in connection with, the first aging house in the city, Taipei Dementia Group Home, to try to archive the following purpose:

1. To explore respectively against Tianmu Group Home and Japanese Group Home, about the background of their establishment, the process of development, service and building environment.
2. Study about behavior and characteristics of uses of space in the group home, and relevance between both.
3. Propose a suggestion that fits the local environment of Taiwan for the group home, to improve the caring system and environmental problems, as to popularize services alike.

About the research methods, first using The Method of Literature Review, study about dementia and elderly, classify the form of their type of behavior, space territory and related theories. And from the background to the establishment, process of development, service and environment of both Japan Group Home and Tianmu Group home as the foundation of this study. In addition, observation through participating and recording in field, according to 2 units in Tianmu Group Home, using analysis between the amount of time versus the time of behavior occurred and the time of space usage, and through model of circulation and graph of occluded space, discuss the behavior and space identity of dementia elderly in Tianmu Group Home and connection between two. Furthermore, concluding this study through these observation and investigation.

After summarize the analysis of this study, for dementia elder in behavior and space, the use of interrelated characteristics, made the following conclusion respectively from the acts, the space and the service dimensions. First, the characteristic behaviors of dementia elderly mainly from the need of behavior, behavioral and psychological narcolepsy. Second, distribution of space is most widely used in leisure behavior, and behavioral psychological walk. Third, usage of behavior and space mainly affected by scheduled activities. Fourth, dementia elderly mostly based in using indoor space. Fifth, activities participating will induced if living room and gourmand kitchen had more flexibility. Sixth, fewer of nostalgic sense of place created, will reduced the sense of stability to the environment of dementia elderly, and could easily lead to the occurrence of behavioral and psychological symptoms. Seventh, adding outdoor and green landscape, will encourage communication between dementia elderly and producing spiritual pleasure and healing effect. Eighth, nurse aide staffing in response mainly concerns about the safety of dementia elderly causing some behavioral and psychological symptoms of dementia elderly. Lastly, based on above observation and analysis, recommend a program to improvement the system.

並列關鍵字

Dementia Elderly ； Group Home ； Tianmu Group Home ； Japan Group Home

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